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ENT Doctor

Private Service, ENT/ Head & Neck Surgery, Paediatrics

Today

Description

Associate Professor Murali Mahadevan is a Specialist Paediatric and Adult ENT surgeon who works 3/10th with Counties Manukau District Health Board, 1/10 University of Auckland and 5/10th in the private sector. He has been a consultant surgeon at ADHB/CMDHB for the last 25 years. He is ex-Clinical Director / Paediatric ENT/Head and Neck Surgeon at Starship Children's Hospital. Murali also has an academic position with the University of Auckland as Associate Professor of Surgery, Department of Surgery, UoA. Murali is double fellowship trained in Paediatric ENT at Great Ormond Street Hospital for Children, London and Royal Children's, Melbourne.

His main practice is located at Suite A, Level 1, Kakariki Hospital, 9-15 Marewa Road, Greenlane.

His subspecialty interests are all aspects of Paediatric ENT, adult Snoring & OSA, adult /children's Nasal and Sinus surgery. He also has extensive experience in paediatric and adult neck lump surgery.

Ear, Nose & Throat Conditions and Procedures

Ear, eardrum and middle ear

Nose and nasal passage
Nasal surgery for deviated septum/ obstruction
Rhinoplasty - cosmetic
Surgery for Sinusitis and Polyps

Videos on Sinusitis

Throat and voice box
Tonsils and Tonsillectomy

Frequently asked questions re Tonsillectomy
Tonsil and Adenoid Surgery

Hoarseness and Voice Changes

Salivary Glands - parotid and submandibular mass/ stone

Salivary Gland Tumours

Sinus and snoring
Nose Correction Surgery for Snoring
Sinus Surgery for Snoring

Surgery for Snoring and Sleep Apnoea

Sleep Disordered Breathing, Snoring & OSA

Tonsil and Adenoid Surgery

OSA- Sleep apnoea
Overview on OSA and snoring


Cosmetic

Otoplasty - Surgery for Bat Ears and Prominent Ears

Cosmetic Nose Surgery

Head and neck
Branchial Cysts

Dermoid Cysts

Salivary Gland Masses & Tumours

Thyroglossal Duct Cys
t
Neck Cysts/Lumps/Lymph Nodes

Click here to view videos on common conditions and procedures of the ear, nose and throat.

Staff

Practice Manager

Mrs Amanda Beeslar

Personal Assistant and Secretary 

Miss Emma Olson

Consultants

Ages

Child / Tamariki, Youth / Rangatahi, Adult / Pakeke, Older adult / Kaumātua

How do I access this service?

Contact us

Phone 09-9254050

This is the best contact if you want to talk to the PA. If they are busy please leave a message - we will contact you as soon as we can.

EMAIL referral:  surgeon@entdoctor.co.nz

Make an appointment

Phone 09-9254050

Fax referral to  09-9254051

Email copy of referral to: surgeon@entdoctor.co.nz

We will confirm within 24 hours.

Referral

Email referral to

surgeon@entdoctor.co.nz 

Referral Expectations

For Patients

Ideally you should have a referral letter from your GP or another doctor. However we can see you without one if appropriate.

 

For GPs and medical professionals:

Management guidelines and tips:

Guidelines for Fractured Nose

Guidelines for Otitis Externa and Discharging Ear Secondary to Grommets

Management of a Child with a Runny Nose

Management of Nose Bleeds

Fees and Charges Description

Dr Mahadevan is a Southern Cross Affiliated Provider for the following treatments. As such he will assist in organising prior approval and claims on your behalf. 

Affiliated Provider services offered:

  • consultations and follow up appointments
  • office based procedures - ENT
  • ear suction
  • OSA surgery
  • adenoidectomy
  • adenotonsillectomy
  • tonsillectomy
  • grommets
  • endoscopic sinus surgery
  • nose surgery-septoplasty
  • neck lump surgery

Hours

Mon – Thu 8:00 AM – 5:00 PM
Fri 8:00 AM – 4:00 PM

Please contact during business hours, 8am - 5pm, Monday to Friday, to book appointments at either clinic. Weekend requests will be processed Monday.

Languages Spoken

Sinhala, English, Tamil

Common Conditions

Otitis Media

This is inflammation or infection of your middle ear (the space behind your eardrum) and is often associated with a build-up of fluid in your middle ear. Acute Otitis Media This is usually caused by a temporary malfunction of the Eustachian tube due to allergies, infections or trauma. The Eustachian tube connects the middle ear to the nose and allows air to enter the middle ear, thus making middle ear pressure the same as air pressure outside the head. Acute otitis media results in an infection in the middle ear causing pain, fever and a red, bulging eardrum (the thin, transparent membrane between the outer ear canal and the middle ear). This condition is usually seen in young children. The treatment may be antibiotics if it is suspected to be a bacterial, rather than viral, infection, or if there are repeated episodes, surgical insertion of grommets into the eardrums may be required. Grommets are tiny ventilation tubes that allow normal airflow into, and drainage out of, the middle ear until the Eustachian tube begins to work normally. The operation is done under general anaesthesia (the child is asleep) and takes 10-15 minutes. Most grommets fall out naturally after six to twelve months, by which time the Eustachian tubes are often working properly. Otitis Media with Effusion (Glue Ear) Like acute otitis media, glue ear is usually the result of a temporary malfunction of the Eustachian tube and may either follow an episode of acute otitis media or occur on its own. The condition is usually seen in children. Fluid is present in the middle ear and the ear is not usually painful, but the ear drum is not red and bulging and there is no fever. Glue ear may lead to hearing loss, which can result in speech delays, and balance problems. Treatment options include: a prolonged course of antibiotics; grommet insertion; or treatment with decongestants, antihistamines or steroids. Chronic Otitis Media If the Eustachian tube is blocked repeatedly over a period of several years, there may be changes to the tissues of the middle ear such as deformity of the ear drum and damage to the bones of the ear. These changes may result in hearing problems, balance problems, and persistent deep ear pain. If such long term damage has occurred, an operation called tympanomastoidectomy may be required. This involves making an incision (cut) behind or around the upper part of your ear, drilling through the mastoid bone and removing, and possibly repairing, damaged tissues. Ear Infections - for Patients (PDF, 458.7 KB) Ear Infections - for Patients (PDF, 458.7 KB)

This is inflammation or infection of your middle ear (the space behind your eardrum) and is often associated with a build-up of fluid in your middle ear.

Acute Otitis Media

This is usually caused by a temporary malfunction of the Eustachian tube due to allergies, infections or trauma.  The Eustachian tube connects the middle ear to the nose and allows air to enter the middle ear, thus making middle ear pressure the same as air pressure outside the head.  Acute otitis media results in an infection in the middle ear causing pain, fever and a red, bulging eardrum (the thin, transparent membrane between the outer ear canal and the middle ear).  This condition is usually seen in young children.  The treatment may be antibiotics if it is suspected to be a bacterial, rather than viral, infection, or if there are repeated episodes, surgical insertion of grommets into the eardrums may be required.  Grommets are tiny ventilation tubes that allow normal airflow into, and drainage out of, the middle ear until the Eustachian tube begins to work normally.  The operation is done under general anaesthesia (the child is asleep) and takes 10-15 minutes. Most grommets fall out naturally after six to twelve months, by which time the Eustachian tubes are often working properly.

Otitis Media with Effusion (Glue Ear)

Like acute otitis media, glue ear is usually the result of a temporary malfunction of the Eustachian tube and may either follow an episode of acute otitis media or occur on its own. The condition is usually seen in children. Fluid is present in the middle ear and the ear is not usually painful, but the ear drum is not red and bulging and there is no fever. Glue ear may lead to hearing loss, which can result in speech delays, and balance problems. Treatment options include: a prolonged course of antibiotics; grommet insertion; or treatment with decongestants, antihistamines or steroids.

Chronic Otitis Media

If the Eustachian tube is blocked repeatedly over a period of several years, there may be changes to the tissues of the middle ear such as deformity of the ear drum and damage to the bones of the ear. These changes may result in hearing problems, balance problems, and persistent deep ear pain.  If such long term damage has occurred, an operation called tympanomastoidectomy may be required. This involves making an incision (cut) behind or around the upper part of your ear, drilling through the mastoid bone and removing, and possibly repairing, damaged tissues.

Tonsils and Adenoids

Tonsils and adenoids are part of Waldeyer's group of lymphoid tissues in the oral and nasopharyngeal cavity. What are Tonsils and Adenoids (DOCX, 1.5 MB) How are Tonsillectomy and Adenoidectomy Performed (PDF, 707.2 KB)

Tonsils and adenoids are part of Waldeyer's group of lymphoid tissues in the oral and nasopharyngeal cavity.

Sinusitis

In the facial bones surrounding your nose, there are four pairs of hollow air spaces known as sinuses or sinus cavities. These sinuses all open into your nose, allowing air to move into and out of the sinus and mucous to drain into the nose and the back of your throat. If the passage between the nose and sinus becomes swollen and blocked, then air and mucous can become trapped in the sinus cavity causing inflammation of the sinus membranes or linings. This is known as sinusitis. Sinusitis can be: acute - usually a bacterial (or sometimes viral) infection in the sinuses that follows a cold, or an allergic reaction. chronic - a long term condition that lasts for more than 3 weeks and may or may not be caused by an infection. Sinusitis can be a recurrent condition which means it may occur every time you get a cold. Symptoms of sinusitis include: facial pain or pressure nasal congestion (blocking) nasal discharge headaches fever. Treatment for bacterial sinusitis is antibiotics and for non-infective sinusitis may include steroid nasal sprays and nasal washes. If this treatment is unsuccessful, surgery may be considered. This is usually performed endoscopically; a tiny camera attached to a tube (endoscope) is inserted into your nose. Very small instruments can be passed through the endoscope and used to remove abnormal or obstructive tissue thus restoring movement of air and mucous between the nose and the sinus.

In the facial bones surrounding your nose, there are four pairs of hollow air spaces known as sinuses or sinus cavities. These sinuses all open into your nose, allowing air to move into and out of the sinus and mucous to drain into the nose and the back of your throat. If the passage between the nose and sinus becomes swollen and blocked, then air and mucous can become trapped in the sinus cavity causing inflammation of the sinus membranes or linings.  This is known as sinusitis.
Sinusitis can be:
  •   acute -  usually a bacterial (or sometimes viral) infection in the sinuses that follows a cold, or an allergic reaction.
  •   chronic - a long term condition that lasts for more than 3 weeks and may or may not be caused by an infection.
Sinusitis can be a recurrent condition which means it may occur every time you get a cold.
 
Symptoms of sinusitis include:
  •     facial pain or pressure
  •     nasal congestion (blocking)
  •     nasal discharge
  •     headaches
  •     fever.
 
Treatment for bacterial sinusitis is antibiotics and for non-infective sinusitis may include steroid nasal sprays and nasal washes.
If this treatment is unsuccessful, surgery may be considered. This is usually performed endoscopically; a tiny camera attached to a tube (endoscope) is inserted into your nose. Very small instruments can be passed through the endoscope and used to remove abnormal or obstructive tissue thus restoring movement of air and mucous between the nose and the sinus.
Snoring

Snoring is the harsh rattling noise made by some people when they sleep. Snoring occurs when the flow of air through the back of the mouth and nose becomes partially blocked and structures such as the tongue, soft palate (the back part of the roof of the mouth) and uvula (the tag that hangs at the back of the mouth) strike each other and vibrate. Causes of snoring include: nasal polyps; a bend in the nasal septum (the partition running down the middle of the nose), large tonsils or adenoids, obesity, smoking, excess alcohol. Surgical treatment of snoring involves soft tissue stiffening procedures and removal of tonsils or excess loose tissue in the throat or soft palate. OVERVIEW ON OSA and SNORING (DOCX, 13.1 KB)

Snoring is the harsh rattling noise made by some people when they sleep. Snoring occurs when the flow of air through the back of the mouth and nose becomes partially blocked and structures such as the tongue, soft palate (the back part of the roof of the mouth) and uvula (the tag that hangs at the back of the mouth) strike each other and vibrate.
 
Causes of snoring include: nasal polyps; a bend in the nasal septum (the partition running down the middle of the nose), large tonsils or adenoids, obesity, smoking, excess alcohol.
 
Obstructive Sleep Apnoea (OSA)

When snoring is interrupted by episodes of totally obstructed breathing, it is known as obstructive sleep apnoea. The obstruction is caused by the relaxation of muscles that support the soft tissues at the back of the throat such as the uvula, soft palate, tongue and tonsils. These tissues then collapse and momentarily block the airway. Episodes may last 20 seconds or more and may occur hundreds of times per night. While you are not breathing, the levels of oxygen in your blood drop which causes your blood pressure to go up and adds strain to your cardiovascular system. In addition, you are likely to feel overly tired during the day and your work, driving and overall performance may be affected. The usual treatment for OSA is to wear a nasal mask that delivers pressurised air to keep the airways open while you sleep. This treatment is known as Continuous Positive Airway Pressure (CPAP).

When snoring is interrupted by episodes of totally obstructed breathing, it is known as obstructive sleep apnoea. The obstruction is caused by the relaxation of muscles that support the soft tissues at the back of the throat such as the uvula, soft palate, tongue and tonsils. These tissues then collapse and momentarily block the airway.
 
Episodes may last 20 seconds or more and may occur hundreds of times per night. While you are not breathing, the levels of oxygen in your blood drop which causes your blood pressure to go up and adds strain to your cardiovascular system. In addition, you are likely to feel overly tired during the day and your work, driving and overall performance may be affected.
 
The usual treatment for OSA is to wear a nasal mask that delivers pressurised air to keep the airways open while you sleep. This treatment is known as Continuous Positive Airway Pressure (CPAP).
Rhinitis

Rhinitis is the inflammation of the lining of the nose (nasal mucosa). The most common symptoms are a blocked, runny and itchy nose. Rhinitis can be: allergic – either seasonal (hay fever) caused by pollen allergies or perennial caused by e.g. house dust mite, pets. infectious – e.g. the common cold non-allergic, non-infectious – caused by irritants such as smoke, fumes, food additives In the case of allergic rhinitis, the specific allergen (the thing that you are allergic to) may be identified by skin prick tests. This involves placing a drop of the allergen on your skin and then scratching your skin through the drop. If you are allergic, your skin will become red and swollen at the site. Treatment of allergic rhinitis involves avoiding the allergen if possible, but if not possible then corticosteroid nasal sprays and antihistamines are the usual medications prescribed.

Rhinitis is the inflammation of the lining of the nose (nasal mucosa). The most common symptoms are a blocked, runny and itchy nose.
 
Rhinitis can be:
  • allergic – either seasonal (hay fever) caused by pollen allergies or perennial caused by e.g. house dust mite, pets.
  • infectious – e.g. the common cold
  • non-allergic, non-infectious – caused by irritants such as smoke, fumes, food additives
 
In the case of allergic rhinitis, the specific allergen (the thing that you are allergic to) may be identified by skin prick tests. This involves placing a drop of the allergen on your skin and then scratching your skin through the drop. If you are allergic, your skin will become red and swollen at the site.
 
Treatment of allergic rhinitis involves avoiding the allergen if possible, but if not possible then corticosteroid nasal sprays and antihistamines are the usual medications prescribed. 
Swallowing Disorders (Dysphagia)

If you find it difficult to pass food or liquid from your mouth to your stomach, you may have a swallowing disorder or dysphagia. Symptoms may include: a feeling that food is sticking in your throat, discomfort in your throat or chest, a sensation of a ‘lump’ in your throat, coughing or choking. A disorder may occur in any part of the swallowing process such as the mouth, pharynx (tube at the back of the throat that connects your mouth with your oesophagus), oesophagus (food pipe that takes food to your stomach) or stomach. Causes of dysphagia include: the common cold, gastro-oesophageal reflux, stroke or a tumour. Diagnosis may be by examination of a mucous sample or by viewing the pharynx, oesophagus and stomach using a small, flexible tube with a tiny camera on the end that is inserted down the back of your throat. Treatments for dysphagia depend on the causes, but may include: medication – antacids, muscle relaxants or medicine to slow down stomach acid production changes in diet and/or lifestyle surgery e.g. stretching or releasing a tightened muscle

If you find it difficult to pass food or liquid from your mouth to your stomach, you may have a swallowing disorder or dysphagia. Symptoms may include: a feeling that food is sticking in your throat, discomfort in your throat or chest, a sensation of a ‘lump’ in your throat, coughing or choking.
 
A disorder may occur in any part of the swallowing process such as the mouth, pharynx (tube at the back of the throat that connects your mouth with your oesophagus), oesophagus (food pipe that takes food to your stomach) or stomach.
Causes of dysphagia include: the common cold, gastro-oesophageal reflux, stroke or a tumour.
 
Diagnosis may be by examination of a mucous sample or by viewing the pharynx, oesophagus and stomach using a small, flexible tube with a tiny camera on the end that is inserted down the back of your throat.
 
Treatments for dysphagia depend on the causes, but may include:
  • medication – antacids, muscle relaxants or medicine to slow down stomach acid production
  • changes in diet and/or lifestyle
  • surgery e.g. stretching or releasing a tightened muscle
Hoarseness

Hoarseness can be described as abnormal voice changes that make your voice sound raspy and strained and higher or lower or louder or quieter than normal. These changes are usually the result of disorders of the vocal cords which are the sound-producing parts of the voice box (larynx). The most common cause of hoarseness is laryngitis (inflammation of the vocal cords) which is usually associated with a viral infection but can also be the result of irritation caused by overuse of your voice e.g. excessive singing, cheering, loud talking. Other causes of hoarseness include: nodules on the vocal cords – these may develop after using your voice too much or too loudly over a long period of time smoking gastro-oesophageal reflux disease (GERD) – stomach acid comes back up the oesophagus and irritates the vocal cords. This is a common cause of hoarseness in older people allergies polyps on the vocal cords glandular problems tumours. Diagnostic tests may include viewing the vocal cords with a mirror at the back of your throat or by inserting a small flexible tube with a camera on the end (endoscope) through your mouth. Sometimes tests may be done to analyse the sounds of your voice. Treatment depends on the cause of the hoarseness and may include resting your voice or changing how it is used, avoiding smoking, medication to slow stomach acid production and sometimes surgical removal of nodules or polyps.

Hoarseness can be described as abnormal voice changes that make your voice sound raspy and strained and higher or lower or louder or quieter than normal.
These changes are usually the result of disorders of the vocal cords which are the sound-producing parts of the voice box (larynx).
 
The most common cause of hoarseness is laryngitis (inflammation of the vocal cords) which is usually associated with a viral infection but can also be the result of irritation caused by overuse of your voice e.g. excessive singing, cheering, loud talking.
 
Other causes of hoarseness include:
  • nodules on the vocal cords – these may develop after using your voice too much or too loudly over a long period of time
  • smoking
  • gastro-oesophageal reflux disease (GERD) – stomach acid comes back up the oesophagus and irritates the vocal cords. This is a common cause of hoarseness in older people
  • allergies
  • polyps on the vocal cords
  • glandular problems
  • tumours.
 
Diagnostic tests may include viewing the vocal cords with a mirror at the back of your throat or by inserting a small flexible tube with a camera on the end (endoscope) through your mouth. Sometimes tests may be done to analyse the sounds of your voice.
 
Treatment depends on the cause of the hoarseness and may include resting your voice or changing how it is used, avoiding smoking, medication to slow stomach acid production and sometimes surgical removal of nodules or polyps.
Hearing Loss

Hearing loss can be divided into two types: conductive hearing loss (caused by some sort of mechanical problem in the external or middle ear) or sensorineural hearing loss (caused by disorders of the inner ear, hearing nerve or associated brain structures). Conductive hearing loss is often reversible and can be due to: blockage of the ear by e.g. wax, inflammation, infections or middle ear fluid poor sound conduction because of e.g. holes or scarring in the eardrum or the bones of the middle ear (ossicles) becoming fixed and rigid. Sensorineural hearing loss is generally not reversible and can be caused by: genetic make-up (this could include congenital conditions i.e. those you are born with, or late-onset hearing loss) head injury tumours infections certain medications exposure to loud noises the aging process (a significant hearing loss is experienced by about one third of people aged over 70 years). Some of the signs you might notice that indicate you have a hearing loss include: having to turn up the volume on the TV or radio finding it hard to hear someone you are talking with finding it hard to hear in a group situation where there is background noise e.g. in a restaurant having to ask people to repeat themselves you find people's speech is unclear - they are mumbling Hearing loss can be partial (you can still hear some things) or complete (you hear nothing) and may occur in one or both ears. Treatment Treatments for hearing loss range from the removal of wax in the ear canal to complex surgery, depending on the cause of the loss. One of the most common treatments for hearing loss is the use of a hearing aid. The type of aid you get depends on the cause of your hearing loss and how bad it is, as well as what your preferences are in terms of comfort, appearance and lifestyle. If your hearing loss is severe to profound, you may be suitable for a surgical procedure known as a cochlear implant. In this procedure, a small cut (incision) is made behind your ear and a device is implanted that can bypass the damaged parts of your ear. The surgery usually takes 2-3 hours and is performed under general anaesthesia (you sleep through it). You may be able to go home the same day or have to spend one night in hospital.

Hearing loss can be divided into two types: conductive hearing loss (caused by some sort of mechanical problem in the external or middle ear) or sensorineural hearing loss (caused by disorders of the inner ear, hearing nerve or associated brain structures).

Conductive hearing loss is often reversible and can be due to:

  • blockage of the ear by e.g. wax, inflammation, infections or middle ear fluid
  • poor sound conduction because of e.g. holes or scarring in the eardrum or the bones of the middle ear (ossicles) becoming fixed and rigid.

Sensorineural hearing loss is generally not reversible and can be caused by:

  • genetic make-up (this could include congenital conditions i.e. those you are born with, or late-onset hearing loss)
  • head injury
  • tumours
  • infections
  • certain medications
  • exposure to loud noises
  • the aging process (a significant hearing loss is experienced by about one third of people aged over 70 years).

Some of the signs you might notice that indicate you have a hearing loss include:

  • having to turn up the volume on the TV or radio
  • finding it hard to hear someone you are talking with
  • finding it hard to hear in a group situation where there is background noise e.g. in a restaurant
  • having to ask people to repeat themselves
  • you find people's speech is unclear - they are mumbling

Hearing loss can be partial (you can still hear some things) or complete (you hear nothing) and may occur in one or both ears.

Treatment

Treatments for hearing loss range from the removal of wax in the ear canal to complex surgery, depending on the cause of the loss. One of the most common treatments for hearing loss is the use of a hearing aid. The type of aid you get depends on the cause of your hearing loss and how bad it is, as well as what your preferences are in terms of comfort, appearance and lifestyle.

If your hearing loss is severe to profound, you may be suitable for a surgical procedure known as a cochlear implant. In this procedure, a small cut (incision) is made behind your ear and a device is implanted that can bypass the damaged parts of your ear. The surgery usually takes 2-3 hours and is performed under general anaesthesia (you sleep through it). You may be able to go home the same day or have to spend one night in hospital.

Refreshments

Chilled water available in the waiting room.

Public Transport

The website https://at.govt.nz/ is a good resource to plan public transport options.

Parking

Free patient parking is provided.

Other

ANZSPO website: www.anzspo.consec.com.au

NZ Society of ORL head neck surgery website: www.nzsohns.org

South Pacific ORL website: www.southpacificorl.consec.com.au

Contact Details

Kakariki Hospital Consulting Suites, Suite A, Level 1, 9 Marewa Road
Greenlane
Albert-Eden
Auckland 1040

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Street Address

Kakariki Hospital Consulting Suites, Suite A, Level 1, 9 Marewa Road
Greenlane
Albert-Eden
Auckland 1040

Postal Address

Suite A, Level 1, Kakariki Hospital, 9-15 Marewa Road, Greenlane, Auckland

This page was last updated at 11:44AM on August 6, 2024. This information is reviewed and edited by ENT Doctor.